title: Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program.
abstract: OBJECTIVE
  Substance-related impairment of physicians is a small but serious problem, with significant consequences for patient safety and public health. The purpose of this study was to identify reasons for prescription drug misuse among physicians referred to a physician health program for monitoring because of substance-related impairment, to develop better mechanisms for prevention and intervention.
  
  
  METHODS
  A total of 55 physicians (94.5% male) who were being monitored by their State physician health program because of substance-related impairment participated in guided focus group discussions. Participation was anonymous. Discussions were transcribed from 9 separate focus groups, lasting 60 to 90 minutes each. Qualitative analyses were conducted to examine themes.
  
  
  RESULTS
  All participants were diagnosed with substance dependence, and 69.1% of them endorsed a history of misusing prescription drugs. Participants documented the following 5 primary reasons for prescription drug misuse: (1) to manage physical pain, (2) to manage emotional/psychiatric distress, (3) to manage stressful situations, (4) to serve recreational purposes, and (5) to avoid withdrawal symptoms.
  
  
  CONCLUSIONS
  Our results emphasize the importance of self-medication as a leading reason for misusing prescription medications, although recreational use was also an important factor. Prevention efforts targeting prescription drug misuse among physicians should be initiated during medical training, with continuing education requirements throughout the physicians' careers.
authors.affiliation: From the University of Florida and Professionals Resource Network, Inc (LJM), Gainesville, FL; Mahidol University (SS), Bangkok, Thailand; Numerof & Associates (SMC), St. Louis, MO; and University of Florida (LBC), Gainesville, FL.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Merlo
authors.forename: Supachoke
authors.initials: S
authors.lastname: Singhakant
authors.forename: Simone M
authors.initials: SM
authors.lastname: Cummings
authors.forename: Linda B
authors.initials: LB
authors.lastname: Cottler
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000009:adverse effects / Q000379:methods; D061214:Patient Safety; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D063487:Prescription Drug Misuse / Q000009:adverse effects / Q000517:prevention & control / Q000523:psychology; D012651:Self Medication / Q000009:adverse effects / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000150:complications / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D014481:United States
chemical_list: D000701:Analgesics, Opioid